Scarlet fever, also known as scarlatina, is an infection that can develop in people who have strep throat. It’s characterized by a bright red rash on the body, usually accompanied by a high fever and sore throat. The same bacteria that cause strep throat also cause scarlet fever.

Scarlet fever mainly affects children between the ages of 5 and 15 years. It used to be a serious childhood illness, but it’s often less dangerous today. Antibiotic treatments used early on in the illness have helped speed recovery and reduce the severity of the symptoms.

A rash is the most common sign of scarlet fever in both adults and children. It usually begins as a red blotchy rash and becomes fine and rough like sandpaper. The scarlet-colored rash is what gives scarlet fever its name. The rash can begin up to two to three days before a person feels ill or up to seven days after.

The rash typically begins on the neck, groin, and under the arms. It then spreads to the rest of the body. The folds of skin in the armpits, elbows, and knees can also become a deeper red than the surrounding skin.

After the rash has subsided, about seven days, the skin on the tips of the fingers and toes and in the groin may peel. This can last for several weeks.

Scarlet fever is caused by group A Streptococcus, or Streptococcus pyogenes bacteria, which are bacteria that can live in your mouth and nasal passages. Humans are the main source of these bacteria. These bacteria can produce a toxin, or poison, that causes the bright red rash on the body.

The infection can spread two to five days before a person feels ill and may be spread through contact with droplets from an infected person’s saliva, nasal secretions, sneeze, or cough. This means that any person can contract scarlet fever if they come into direct contact with these infected droplets and then touch their own mouth, nose, or eyes.

You may also get scarlet fever if you drink from the same glass or eat off of the same utensils as a person with the infection. In some cases, group A strep infections have been spread through contaminated food.

Group A strep can cause a skin infection in some people. These skin infections, known as cellulitis, can spread the bacteria to others. However, touching the rash of scarlet fever will not spread the bacteria since the rash is a result of the toxin not the bacteria itself.

In most cases, the rash and other symptoms of scarlet fever will be gone in about 10 days to 2 weeks with antibiotic treatment. However, scarlet fever can cause serious complications. These can include:

Ear infections, throat abscesses, and pneumonia can best be avoided if scarlet fever is treated promptly with the proper antibiotics. Other complications are known to be the result of the body’s immune response to the infection rather than the bacteria themselves.

Your child’s doctor will first perform a physical exam to check for signs of scarlet fever. During the exam, the doctor will particularly check the condition of your child’s tongue, throat, and tonsils. They’ll also look for enlarged lymph nodes and examine the appearance and texture of the rash.

If the doctor suspects your child has scarlet fever, they’ll likely swab the back of your child’s throat to collect a sample of their cells for analysis. This is called a throat swab and is used to create a throat culture.

The sample will then be sent to a laboratory to determine whether group A Streptococcus is present. There’s also a rapid throat swab test that can be performed in the office. This may help identify a group A strep infection while you wait.

Scarlet fever is treated with antibiotics. Antibiotics kill bacteria and help the body’s immune system fight off the bacteria causing the infection. Make sure you or your child complete the entire course of the prescribed medication. This will help prevent the infection from causing complications or continuing further.

You can also give certain over-the-counter (OTC) medications, such as acetaminophen (Tylenol), for fever and pain. Check with your doctor to see if your child is old enough to receive ibuprofen (Advil, Motrin). Adults may use acetaminophen or ibuprofen.

Aspirin should never be used at any age during an illness with fever due to the increased risk of developing Reye’s syndrome.

Your child’s doctor might also prescribe other medication to help ease the pain of a sore throat. Other remedies include eating ice pops, ice cream, or warm soup. Gargling with salt water and using a cool air humidifier can also decrease the severity and pain of a sore throat.

It’s also important that your child drink plenty of water to avoid dehydration.

Your child can return to school after they’ve taken antibiotics for at least 24 hours and no longer have a fever.

There’s currently no vaccine for scarlet fever or group A strep, although many potential vaccines are in clinical development.